Provider Demographics
NPI:1790547719
Name:RODRIGUEZ PEREZ, JOSHUA EMIL
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:EMIL
Last Name:RODRIGUEZ PEREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 CALLE 54 SE
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-2730
Mailing Address - Country:US
Mailing Address - Phone:787-324-7544
Mailing Address - Fax:
Practice Address - Street 1:CARR. 842 KM. 2.6 CAMINO LAS CATALAS BO.CAIMITO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0092
Practice Address - Country:US
Practice Address - Phone:787-790-9009
Practice Address - Fax:787-720-4557
Is Sole Proprietor?:No
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR008183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist